国人青光眼视网膜中央动脉和眼动脉血流改变的Meta分析  

Meta-analysis of glaucomatous hemodynamic changes in ophthalmic artery and central retinal artery in China

作　　者：周钢[1] 

机构地区：[1]中国广东省广州市第十二人民医院眼科,510620

出　　处：《国际眼科杂志》2007年第3期720-726,共7页International Eye Science

基　　金：2005年广东省医学科学研究基金资助(No.A2005601)~~

摘　　要：目的:综合评价青光眼视网膜中央动脉(CRA)和眼动脉(OA)血流动力学改变的诊断意义和临床应用。方法:计算机网上检索中国期刊全文数据库1994/2006有关CRA和OA彩色超声多普勒血流动力学测定的青光眼病例-对照研究文献40篇,对CRA和OA血流参数进行同质性检验和合并效应量的检验。结果:合并分析后有统计学意义的同质性研究结果为青光眼对侧未损害眼的OA与CRA收缩期峰值血流速度比正常人分别降低0.55～0.68和0.41～0.51个标准差,舒张末期血流速度比正常人降低0.22～2.52和0.69～0.79个标准差,OA和CRA阻力指数分别高于正常人1.13～1.29和0.51～0.61个标准差。抗青光眼术后OA平均血流速度比正常低0.23～0.32个标准差,CRA阻力指数比正常高0.04～1.51个标准差。正常眼压性青光眼(NTG)的CRA的收缩期峰值和舒张末期血流速度比正常人分别低0.71～0.79和0.68～0.77个标准差,却比原发性开角型青光眼(POAG)患者高0.03～0.12和0.04～0.13个标准差。闭角型青光眼的CRA搏动指数比正常人和POAG患者分别降低0.04～0.11和0.33～0.40个标准差。高眼压组的OA舒张末期血流速度分别比低眼压组降低1.61～1.82,1.01～1.26,0.47～0.79个标准差,阻力指数分别比低眼压组增加0.57～0.73,0.82～1.06,0.03～0.34个标准差。合并分析后有统计学意义的结果是慢性闭角型青光眼(CCAG)的OA平均血流速度和CRA收缩期峰值血流速度比正常人分别降低0.06～2.25和0.34～3.81个标准差。结论:各型原发性青光眼缺血性改变最明显的是POAG,其次为NTG,CCAG。NTG的CRA收缩期峰值和舒张末期血流速度下降明显;CCAG的OA平均血流速度和CRA收缩期峰值血流速度下降明显;POAG的CRA阻力指数增加明显。抗青光眼术后彩色超声多普勒检测OA和CRA血流动力学参数,发现其缺血性改变程度,是重要的疗效评价方法和指标。AIM： To evaluate the diagnostic effects of hemodynamic changes of ophthalmic artery （OA） and central retinal artery （CRA） on glaucoma. HETHODS：The hemodynamic parameters measured with color Doppler ultrasonography from 40 research articles from 1994 to 2006 were cited and analyzed with meta-analysis in homogeneity test and combined test. RESULTS： The homogeneous research results of the parameters induded the decrease of peak systolic velocity （0.55-0.68, 0.41-0.51 Standard Deviation, SD; respectively）, end diastolic velocity （0.22-2.52, 0.69-0.79 SD; respectively） of Oh, and CRA in glaucomatous contralateral non-damaged eyes; OA mean velocity （0.23-0.32 SD） in post- operation patients with glaucoma; OA peak systolic velocity and end diestolic velocity （0.71-0.79, 0.68-0.77 SD; respectively） in normal tension glaucoma （NTG）, CRA pulsatility index （0.04-0.11 SD） in angle-closure glaucoma, and Oh, mean velocity （0.06-2.25 SD） and CRA peak systolic velocity （0.34-3.81 SD） in chronic angle-closure glaucoma （CCAG）, compared to the normal. Resistive index of CRA increased in glaucomatous contralaterel non-damaged eyes （0.51-0.61 SD） and in post- operation patients with glaucoma （0.04-1.51 SD）, compared to the normal. OA end diastolic velocity in higher intraocular pressure group were reduced by 1.61-1.82, 1.01-1.26 and 0.47-0.79 SD, compared to the normal, slight, and mild intraocular pressure group, respectively. CONCLUSION： Ischemic changes of hemodynamics in OA and CRA are one of major pathogenetic factors of glaucomatous neuropathy damage, not only primary causative risk factor but also secondary additional effect. These changes are more severe in primary open-angle glaucoma （POAG） than in NTG and CCAG. Characteristics of the changes differ in NTG with low peak systolic and end diastolic velodties of CRA, in CCAG with low peak systolic velocity of OA and mean velocity of OA, in POAG with high resistive index. Hemodynamic parameters measured by c

关 键 词：META分析 青光眼 血流动力学 

分 类 号：R775[医药卫生—眼科]